Your foot is composed of 26 bones, 33 joints and a host of soft tissues in the form of muscles, tendons and ligaments. Every structure plays a key role in shaping and supporting your foot, and if one part can’t do its job effectively, it can cause problems for the entire foot complex. One problem that can cause trouble for the rest of your foot is tendon damage.
Your tendons act as a mechanical bridge between muscles and bones, and if they become damaged or they suffer from natural degeneration, they may no longer be able to transfer energy or provide support to your foot. In these instances, your foot specialist may recommend a tendon transfer procedure. We take a closer look at what a tendon transfer entails in today’s blog.
What Is A Tendon Transfer And Who Needs One?
As the name of the procedure suggests, a tendon transfer procedure involves taking part of a healthy tendon from another area and using it to replace the damaged tendon in the foot, which in turn helps to restore normal foot shape and function. Typically the tendon is harvested from somewhere else in the foot and ankle complex.
For example, in patients who need a tendon transfer to fix an issue with their posterior tibial tendon, the surgeon will likely harvest the flexor halluces longus, which is a tendon in your foot that helps to control your big toe. This tendon runs along the same path as your posterior tibial tendon, and because the flexor halluces longus is not the only tendon that helps with big toe movement, you’ll still retain normal flexibility in the toe even if the tendon is harvested for a transfer. While different tendons may be harvested given your specific situation, the same type of tendon mapping is considered to ensure that any tendon taken will not affect other movements in the foot complex.
Some conditions that may require a tendon transfer to treat in the event that non-operative care failed to provide relief include:
- Posterior Tibial Tendon Tears
- Flexible Flatfoot
- Charcot-Marie-Tooth disease
- Foot drop
However, in order for a tendon transfer to be considered, certain factors must also be present, including:
- The muscles attached to the tendon needs to be functional; and
- The area that will receive the tendon should be functional, as damage or scarring can complicate the transfer process; and
- The joints through which the tendon will pass should be functional and stable.
Tendon Transfer Procedure
If the patient is an ideal candidate for a tendon transfer procedure, the operation will begin with the patient being placed under general anesthesia. Next, a small incision is made along the foot in order to access the damaged tendon. This tendon is removed, and a healthy tendon is cut and rerouted through soft tissues and bones before being sutured to another bone in the foot with plastic screws or anchor sutures. The soft tissues and incision site are then closed, and your foot will be placed in a splint before you are taken to a recovery room.
You’ll need to protect the area for a number of weeks while the tendon and foot recovers from the trauma of surgery, so patients are oftentimes told to expect to be non-weight bearing for at least six weeks after their operation. The splint is removed around the two-week mark, at which time you can expect to have your foot placed in a cast or surgical boot, which typically remains on your foot for 12 weeks. You will partake in physical therapy sessions over the course of these 12 weeks to strengthen the foot complex at a time when it is non-weight bearing or limited weightbearing. Most patients experience great results by the end of their rehab.
For more information about the foot tendon transfer, or to talk to a foot and ankle specialist about a different issue you are dealing with, reach out to Dr. McDonald and his team today at (860) 244-8889.